In recent decades, there’s been a slow but significant shift in the way American health care is organized. Financial, regulatory, and technological forces have all tended to push hospitals and other medical providers into the fold of larger, integrated health systems. According to the American Hospital Association, 68% of U.S. hospitals are now system-affiliated. To address that trend, the 100 Top Hospitals program, which for decades has ranked America’s best-performing hospitals in an effort to drive industry-wide improvement, launched a list that applies the same rigorous analysis to the nation’s growing number of health systems 16 years ago.
For this year’s Fortune/PINC AI 15 Top Health Systems, researchers from PINC AI—the technology platform for the health care company Premier—drew from a study of 355 health systems across the U.S. using publicly available Medicare data. (Systems had to have at least two general, acute care hospitals to be included in the study).
The analysis took into account data from every hospital within a system, and considered eight performance indicators, like inpatient mortality and average length of stay, that measure an organization’s clinical outcomes, operational efficiency, and patient experience. The top-ranking systems, divided into three groups—large, medium, and small—outperformed their peer systems on all eight measures. These were meaningful differences: rates of hospital-acquired infections and inpatient mortality, for example, were both 21% lower for winning systems than non-winning peers. For the best-performing large systems, inpatient mortality was 32% lower according to the study.
If all health systems performed as their top-rated peers, the analysis found, there would be 220,000 fewer patient deaths and 196,000 fewer patients to suffer complications during their hospital stay. In addition, the typical patient would spend half a day less in the hospital and the costs of their care would be 2% less. Most of the winning systems have been recognized on this list before; the Mayo Clinic, which ranks second among large systems this year, has appeared 12 times.
As is always the case, health systems do not apply for the 15 Top Health Systems selection process, and winners do not pay to market their honor.
5 Top Large Health Systems
1. Intermountain Health
Location: Salt Lake City
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★★★
Total number of years on 15 Top list: 2
Website
2. Mayo Clinic
Location: Rochester, Minn.
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★★★
Total number of years on 15 Top list: 12
Website
3. Houston Methodist
Location: Houston
Clinical outcomes: ★★★★★
Operation efficiency: ★★★
Patient experience: ★★★★★
Total number of years on 15 Top list: 2
Website
4. HCA Continental Division
Location: Denver
Clinical outcomes: ★★★★★
Operation efficiency: ★★★
Patient experience: ★★★★
Total number of years on 15 Top list: 4
Website
5. Sutter Health
Location: Sacramento
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★
Total number of years on 15 Top list: 2
Website
5 Top Medium Health Systems
1. HCA Mountain Division
Location: Cottonwood Heights, Utah
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★
Total number of years on 15 Top list: 2
Website
2. CHI Saint Joseph Health
Location: Lexington, Ky.
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★
Total number of years on 15 Top list: 2
Website
3. Saint Francis Health System
Location: Tulsa
Clinical outcomes: ★★★★★
Operation efficiency: ★★
Patient experience: ★★★★★
Total number of years on 15 Top list: 1
Website
4. Munson Healthcare
Location: Traverse City, Mich.
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★★★
Total number of years on 15 Top list: 2
Website
5. Ascension Sacred Heart Health System
Location: Pensacola
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★★
Total number of years on 15 Top list: 1
Website
5 Top Small Health Systems
1. CHI Memorial
Location: Chattanooga
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★★★
Total number of years on 15 Top list: 3
Website
2. Franciscan Sisters of Christian Charity Sponsored Ministries
Location: Manitowoc, Wis.
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★★
Total number of years on 15 Top list: 3
Website
3. Olathe Health
Location: Olathe, Kan.
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★★★
Total number of years on 15 Top list: 1
Website
4. Ascension St. Vincent's HealthCare
Location: Jacksonville
Clinical outcomes: ★★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★★
Total number of years on 15 Top list: 1
Website
5. ThedaCare
Location: Appleton, Wis.
Clinical outcomes: ★★★★
Operation efficiency: ★★★★★
Patient experience: ★★★★
Total number of years on 15 Top list: 1
Website
Fortune partnered with PINC AI on the 2024 rankings of the 100 Top Hospitals, 50 Top Cardiovascular Hospitals, and the 15 Top Health Systems in the U.S. Learn more about the lists and see which community and teaching hospitals ranked high among their peers below.
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15 Top Health Systems: Methodology
100 Top Hospitals: Introduction - 40 Top Teaching Hospitals
- 60 Top Community Hospitals
- 50 Top Cardiovascular Hospitals
PREMIER, PINC AI, 100 TOP HOSPITALS, 15 TOP HEALTH SYSTEMS, and 50 TOP CARDIOVASCULAR HOSPITALS are registered/unregistered trademarks of Premier Healthcare Alliance, L.P. in the United States.
